In many industries, it is very important for certain devices to operate appropriately, and for the appropriate amount of materials to be utilized. In some situations, a malfunctioning device or an inappropriate amount of materials may cause significant problems. While an increasing number of machines include safety devices (e.g., automatic shut-off, monitoring gauges, alarms, etc), it is often time-consuming, complicated and expensive to monitor numerous safety devices. More specifically, if the machines are located in different areas, it may not be practical for one person to be able to monitor all the machines at one time. Similarly, one person may be busy or not hear an alarm, so a need exists to notify multiple people of a potential safety problem, and provide various methods of notification.
Moreover, when many machines are in a certain area, it may be difficult to determine which safety device associated with one of the various machines needs attention. Furthermore, if many safety devices are activated at the same time, or a certain safety device often activates, then the perceived “urgency” is often reduced, and the monitoring person may not feel the need to react as quickly.
Many safety devices also include generic alarms without any diagnostic data, wherein the diagnostic data indicates the cause of, or information related to, the safety violation. As such, the monitoring person is not able to quickly determine if the alarm is a critical issue, or a minor malfunction. As a result, the monitoring person typically spends valuable time diagnosing the problem. However, the diagnosis time could be better utilized correcting the problem, particularly if the problem is critical and expanding.
The criticality of monitoring machines and quickly diagnosing problems is highlighted in certain industries where the machines are imperative for survival, such as in the medical field. For example, an incorrectly programmed infusion pump 105 or a disconnection of a ventilator imposes a serious safety threat to patients. Incorrectly programmed infusion pumps 105 or disconnected ventilators may result in a significant number of incident reports and alerts. For example, hundreds of valid pump alerts may occur within a one year period at a single hospital. Some of the incidents may result in a physiological change in a patient due to the incorrectly programmed pump. Furthermore, eExisting infusion pumps 105 (e.g., smart pump technology) do not prevent programming errors based on rate percentage increases or unit specific protocols. Moreover, certain high-risk medications have narrow therapeutic indexes and require careful titration for maximal effect.
Additionally, ventilators may transmit an alarm when a disconnection, breathing pattern change, or leak is detected. Issues related to ventilator alarms may be divided by ventilator use in the ICU and ventilator use in the surgical suite during anesthesia. According to numerous studies, the response times to auditory alarms is significantly shorter than visual alarms since visual alarms require the anesthetists to be looking at the monitor in order to see the alarm. However, a study of 64 anesthetists assessed 10 common operating room alarms for perceived urgency and only 33 percent were correctly identified. (Finley Ga, Cohen A J. Perceived urgency and the anesthetists: responses to common operating room monitor alarms. Can J Anaesth. 1991; 38(8):958-64.) Another study that focused on the complications of mechanical ventilation in the ICU, listed the repeated sounding of the ventilator alarms (false positive alarms) as a major reason why clinicians are called to the bedside. (Keith R L, Pierson D J. Complications of mechanical ventilation. A bedside approach. Clin. Chest Med. 1996; 17(3):439-51.) An Australian study of 2,000 incident reports identified 317 incidents that involved problems with ventilators and the majority (47%) was caused by disconnections. (Russell W J, Web R K, Van der Walt J H, Runciman W B. The Australian incident monitoring study. Problems with ventilation: an analysis of 2002 incident reports. Anaesth. Intensive Care. 1993;21(5):617-20.) A study to determine the predictive value of alarms from pulse oximeters, end-tidal PCO2 monitors, ventilators, and electrocardiographs in a pediatric ICU found that 68% were false and the positive predictive value for ventilator alarms was only 3%. (Lawless ST. Crying wolf: false alarms in a pediatric intensive care unit. Crit Care Med. 1994; 22(6):981-5.) Likewise, another study found that of 1,455 alarm soundings in the ICU, only 8 (0.5%) indicated potentially life-threatening problems. (O'Carroll T M. Survey of alarms in an intensive therapy unit. Anesthesia. 1986; 41(7):742-4.)
While the alarm systems built into all ventilators today have become very accurate at identifying critical events (Bender H J, Frankenberger H, Ryll C, Albrecht M D. The performance of respirator alarms during simulated critical events in CMV/IPPV artificial respiration. Anesthesist. 1993; 42(6):365-75. Kacmarek R M, Meklaus G J. The new generation of mechanical ventilators. Crit Care Clin 1990; 6(3):551-78.), too often the resulting alarms go unnoticed for excessive periods of time. This results from a system problem that is outside of the control of the ventilator. This may be due to, for example, the physical layout of the ICU, staffing limitations, staff complacency due to numerous false alarms and/or environmental acoustics and noise. Another serious problem is when patients who are in isolation for infection experience a critical ventilator event. The closed doors can prevent hospital personnel outside the room from hearing or seeing standard ventilator alarms. (Morganstern M S, Karpel S K. Modification of an external low-pressure ventilator alarm to allow its remote use for isolated patients. Respir Care. 1986; 31(5):395-401. Stelfox H T, Bates D W, Redelmeier D A. Safety of patients isolated for infection control. JAMA 2003; 290:1899-905.) In some situations, the ventilator alarm is heard, but valuable time can be lost while the clinician tries to determine which patient or room in the unit activated the alarm. Moreover, current systems do not provide respiratory care management with information on the duration of the critical events, especially with regard to ventilator disconnections.
A need exists for a system and method that minimizes or prevents the affects of programming errors, and/or provides more specific safety violation information to multiple healthcare providers and/or locations.